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HomeMy WebLinkAboutPermit Septic Tank 1994-1-5 (2) . , . T PERMIT # S3~-97" . REQUEST _ FOR: "7r=PT// <~-5TE""h7 ,~~'.5ljif,~n . :, I TOWNSHIP RANGE SECnON 114 SECTION TAX LOT .1.7-0--:' ~-a;? i:A-Ar 02706. Jfr-~'''/I~O'h;}.;q 04.D ,//'. SlRUCTUfll:.lf NO'lf ON PI OI"EUT VA""/'7/'/7 C-./f/9L? -SEPTIC INSTALLED WATER WSTALL.ED '".. I LOT I PARCEL .lOCK J?"-o./?..-.-.-.-_. /-;efi ECErVEo- SU8D1VISIQHI PAllnTlOfll MA"(""<,,,"<' -=:'...-.:>h. PROPOSED USE NO. OF STORIES ,t NO. OF DlPLOY'iiS CONSTJIIUCTlON COSTIVALUE -;;!J1/~'p. <'P/-'C> //-?!?3/.-p ~ T ~.7 2; JMI 0 ~ ~994 DESCRIPTION Of' PROPOSED WORk C::d?,I<'?7?-3v'~T 6A.<:>"-c/? ~ c:::;,.y;<:i'/' OIRECTlONS TO SITE FROM COURTHOUSE .- ""..- " ,. ~.1;.i-'~....:::::: /~:.z> .,;rA:;>.;*Zj.//,;-" /~. -I 6d/.~[ .7"'~,..,>"" ~M~'eJl'!15N rv ~"I\lIC(,\f\I"~!:f\\T61 ~I=Al TH /7' h'A t..':?~ APPLll:;ANT NAME'i ADDRESS .:'~:';C;;-:'''''' rF-> <Y ~~/~T /#<" /.q.-ytY'k";~' 99 "r(fthJ&GV,.-,r: 'OWNERS NAME" ADDRESS . / " I%:.::~ ,-X-/.?4CA7:J"L':'-, -:'fA..---,' e CONTRACTOR NAME ~ .J2~&:;~O /"'h"'~' ~-f.J?"oy~.- 0511 UCENSE' ~.d,.-7''''''?3c=~,'";>r. ;;C;:;2:..So'/.--"" aR ,G..c.,lJ. ~'5'"S-o ) MAIL PERMIT TO: l:'o/"'P/~"',?, .v/v/~"""Y ;;;;;;:>-/\'~ ~--:a. '?7,7;~~'7 _ /./l'?//:,.:-/-Zc&.F;o": ""';/7r COr -:S~.p. --<-=A/..y",_/">~c;~ ,~. ''7--:/v-::)-:;> t NAME .l.'1)'--;-.~"""'- ~ II III.. I I have carefully read BOTH sIdes of this application and hareby certify that all Information Is true and corract ?/1".J#~/..oI/f/ ~_ - ,. h-~~--:>-s A/ W/ CO;-;;J /-/7'-=:;' PHONE 6~C;9~~ PHONE PHONE hH/ -~..// !. , . \ PRNTNAME SiQnarure '^'" ., , PL4NN/NG/ZON/NG,\ READ CAREFULL VI Your Authorization Is Based On The FOllowlnq Conditions ....1. ~ $ APPROVED BY: DATE . CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065 . SEPTIC permits are good for one year, ALL other permits expIre after 180 days unless Inspections are current, ) ~~~ ~h,~~\lq~ ~:, .' VIOLATIONS ! , SETBACKS AND OTHER CONDmONS OF APPROVAL MUST BB STRlCJt. Y OBSERVED. VIOLATION CAN RRStn...T IN REVOCATION OFnDS PERMIT. CITATIONS MAY BE ISSUED UNDER niB PROVISIONS OP LANE COUNTY'S INFRACI10NORDlNANCE AND/OROTIiER REMEDIES All..OWBD BYLAW. " ,/ A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GNEN FOR INSPECTION REQUESTS Have the following information ready when you call: 687-4065 Permit number - Job address - Type of inspection required -- When it will be ready Your name and phone number - Any special directions to the site . , PUBLIC OFFICIAL RIGIIT TO TRESPASS ON PRIVATE PROPERTYORS ns.080 _ POWER TO BN'I'ER UPON LAND. nIB COMMISSION, AND ANY OF ITS MEMBERS, OPFlCERS AND EMPLOYES, IN TIm PERFORMANCE OF TI-JEIR FUNcnONS, MAY ENTER UPON ANY LAND AND MAKE. EXAMINATIONS AND SURVEYS AND PLACE AND MAINTAIN niB NEC!SSARY MONUMENTS AND MARKERS TI-IEREON. REQUIRED INSPECflONS POUNDA nON INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place. UNDERGROUND PIPING INSPECflON: To be made after all underground piping has been installed, prior to any backfill. CONCRETE SLAB OR UNDER-FLOOR INSPECflON: To be made lifter all in.slab or under-floor building service equipmen~ condui~ piping accessories and other ancillary equipment items are in place but ~fore any concrete ispla~d or floor sheathing installed, inCluding the subfloor. ROUGH MECHANICAL INSPECflON: To be made after all ducting and gas piping has been installed and prior to being covered. ROUGH PLUMBING INSPECflON: To be made after all plumbing rough.in is in place, prior to being covered, FRAMING INSPECflON: To be made after the all framing, fife blocking, bracing and roof arc in place and all pipes, chimneys and vents are complete and the rough electrical, plumbing~ and mechanical inspections have been made and approved. . -. . INSULATION INSPECflON: To.be made aftCr all insulation and vapor barriers are.in place, prior to covering. LATH AND/OR GYPSUM BOARD INSPECflON: To be made after all lathing and gypsum board, interior and exterior, is in place but before any plastering is applied or before gypsum board joints and fasteners are taped and ftnished. . ADDITIONAL INSPECTIONS MAYBE REQUIRED, such as but not limited to'; - , BLOCKW ALL: To be made after reinforcing is in place, but before any grout is poured. The ,inspection is required for each bond beam pour. There will be no approval until the plumbing and electrical inspections have been made and approved.. FINAL MECHANICAL INSPECflON: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipment FINAL PLUMBING INSPECflON: To be made just prior to the building, structure or remodeled area being occupied, FINAL BUILDING INSPECflON: To be made after finish grading and the building, structure or remodeled area is completed and ready for occupancy,' . , MOBILE/MANUFACTURED HOMES: An inspection is required after the mobile home is connected to an'approved sewer or septic system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections. Footings and piers to comply with State fOlmdation requirements for mobile homes or as recommended by the manufacturer. Minimum ftnished floor elevation shall be certified when required by Floodplain Management Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be ins~led per enclosure. APPROVAL REQUIRED No work shall be done on any part of the building or structure beyond the point indicated in each successive inspection without ftrst obtaining the approval of the building official. Such approval shall be given only after an inspection shall have been made of each successive step in the construction as indicated by each of 1l!e inspections required. APPROVED PLANS MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS, TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTI1IIN 180 DAYS, OR IF WORK IS STOPPED OR ABAND<JNED FOR MORE TIlAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON TIlE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEI~ OWN RISK. Your signature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do hereby certify that all information hereon is true and correct, and that I have a legal interest in the property as owner of record or authorized agent. I further certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the laws of the State of Oregon per. taining to the work described herein. I further certify that if I am not the owner of the y.v.t^'.~i, my registration with the Builders Board is in full force and effect as required by ORS 701.055, and that if exempt the basis for the exemption is noted'hereon, and that only subcontractors and employees who are in compliance with ORS 701.005 will be used on the job. SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS: When subsurface construction is complete, the permit holder shall notify the County Land Management Division by sllbmitting the installation record ~orm. An inspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of completion will be issued to the pennit holder. If construction does not comply with rules, the permit holder will be notified, and all corrections shall be made before a certificate of completion will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule. SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK ' DRAlNFIELD From: Interior property lines 10' 10' Edge of road right-of-way 10' 10' Building foundation 5' 10' Wells or other water sources 50' 100' Lane County TO: FROM: SEWAGE DISPOSAL SYSTEMS PERMIT APPLICANTS LANE COUNTY ENRIVONMENTAL HEALTH SERVICES You are required by law (OAR 340-71,160) to be in possession of a permit authoriz, ing installation of sewage disposal system before construction of your septic sys- tem can begin. In addition, the law specifies that all work on said system must be performed by the owner or contract purchaser or his regular employees or a person licensed with the State Department of Environmental Quality to per- form sewage disposal services. You should read carefully all the specifications on the installation permit before starting any digging. If you have any questions regarding installation procedures or specifications or the approved area, call your area sanitarian at 687-4051 and they will be glaD to assist you. If you intend to hire someone to do the work for you, you should make sure that the person is licensed with the State Department of Environmental Quality to per- form such work. This protects you, a~ the consumer, as each licensed installer has to post a bond and is liable for the work performed. To check the licensing of an individual you can call Lane County Environmental Heallh Services at 687-4051 and we will check for you to see if the individual or contractor you have chosen is licensed. A file on each licensed installer is available for. review upon request in this office. In addition, the law requires the installer to deliver to each person for whom he performs sewage disposal services, prior to completion of such services, a written notice of the name and address of the surety company which has executed the bond and of the rights of the recipient of such services as provided by subsection (2) or ORS 454.705. We urqe you to request this from the installer or contractor you have chosen prior to hiring them. When the construction of your septic system is complete and before you backfill it is necessary to have the system inspected. To obtain an inspection, make a drawing of the system as installed on the form provided. Submil the completed form to this office and the inspection will be scheduled. Final insoection for sewaae svstems cannot be reauested bv teleohone. Do not hesitate 10 contact Lane County Environmenlal Heallh Services if you have any questions. LANE COUNTY ENVIRONMENTAL HEALTH SERVICES 125 E. 8th Avenue / Public Service Building (503) 687-4051 I Eugene. Oregon 97401 i'l55-98 07/91 l> =:; ro r col :;- "0 :;- 0 ". iD en >2- :> <D er ". en 0. :> "0 er :> en =r ~ '" <D 0 2- iD <0 en 0. 0 Z 0 OJ 0 0 Z '< 3 '" 0 "0 3 '" <D " :> :> '< Qo <D l> T 0. . 0. m en en o 0 '" '" CD co VICINITY MAP ~ 'N L1 MUST BE IN BLACK INK Permit No. BP 00.5;3 - 9-, Twnshp. _17 Range 193 Section ~ 2- Standard System ~Alternative System c:; (Specify TYl2e\ Job Location (Street Address) ~5&' J./a .loDuJ fCCi, S {;)r, ~.P.:J{) Supdivision/Partition #. Parcel Lot lorm c55.11 . Tax Lot :1.7t<J() Block DETAIL SYSTEM PLOT PLAN AS CONSTRUCTED Scale ; ~ N USE BLACK INK ONLY FOR INSTALLER'S USE: Trench Depth Gravel Depth Below Tile Tank Capacity, Manufacturer. Measured Distance from Well to Tank , From Drainfield Total Length of Lines COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION: I (installer's name) certify that a (Mfg.l, (Model No.) Pump and Mercury Float Switch (Mfg. and No.) nave been installed with this sewage installation. Signature ~ Datp FOR SANITARIAN'S USE ONLY: COMMENTS: c:; System Approved D System Disapproved [J Needs Correction System Capacity D System Corrected Date Date gal./day Signature INSTAllATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, this certificate is evi- dence as per ORS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above location. To request inspection. return all three (3) copies of this form to: Lane County Environmental Health Services. located in the basement of the Public Service Building. 125 E. 8th Avenue, Eugene. OR 97401.